| NPI | 1154676294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 60532) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ TP01462) |
| 207R00000X Internal Medicine (Licence: MI 4301101032) | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2022-09-09 |